Denays Roger, Kumba Claudine, Lison Dominique, De Bels David
Department of Neurology, Brugmann University Hospital, Free University of Brussels, Brussels, Belgium.
Epilepsia. 2005 Jun;46(6):961-2. doi: 10.1111/j.1528-1167.2005.70004.x.
Toxic causes of seizures are numerous: alcohol and other substances of abuse, drugs, and industrial and household products. However, in the absence of a clearly suggestive history and/or associated symptoms and signs, identification of the toxic origin of new-onset seizures may be extremely difficult. We report here the case of a patient admitted in our hospital after a single generalized tonic-clonic seizure. The remarkable coincidence that a colleague of his, with whom he was working to clean the same workshop, had been admitted 1 week earlier for respiratory distress, coma, and de novo nonconvulsive focal status epilepticus, led us to consider a possible toxicologic etiology. Urine analysis revealed a high nickel concentration, suggestive of acute nickel poisoning.
